Conclusive result or not?

[Doglover55]

Hello, I am sure the story I have is not unique, but every time I search for answers I come up with more questions. So maybe if I just tell you my situation you can put my anxiety to rest. I tested negative at 52 days to a HIV antigen/antibody test. My exposure was with a man who said he was clean of stds(I'm healthy mid 30s female, I do have hashimotos and take Armour and cytomel). We both performed unprotected oral sex. I tried to move before he came but may not have been quick enough. Prior to that he rubbed around my vagina and anal area a lot and a few times inserted but I would make him withdraw without any further pumping. I didn't have any symptoms that I recall, but now at 9 weeks I'm fretting that a tingling in my arm and nagging headache are delayed symptoms. Does the test I took really mean conclusive? My GP thinks it is, but CDC says 3 months and so many sites are conflicting!! I want to believe it but can't quite. Taking the first test was stress inducing beyond belief. Any thoughts? I worry about a window between the p 24 antigen no longer being detected but the antibody not yet detectable. Also worried that I could have delayed response so wouldn't be detectable at 52 days. Are the three month people the ones who test at 2 weeks or their first time is at three weeks?

[jkinatl2]

Hello!

I am sorry you are fretting about this. Oral sex is not considered a tangible risk for HIV transmission, and seeing as how you did not have unprotected vaginal or anal sex, your test is absolutely reliable.

If you HAD a legitimate risk (you did not) a test at six weeks is considered all but solid - but ONLY a test at the three month window is considered absolutely reliable according to the current "gold standard."

Use a condom for penetrative vaginal and anal sex and you will prevent HIV. It really is that simple

[Ann]

Prior to that he rubbed around my vagina and anal area a lot and a few times inserted but I would make him withdraw without any further pumping.

DL,

It is unclear from the portion of your post I quoted above whether you are talking about being rubbed and penetrated with a finger, or with a penis.

If it was a finger, then you did not have a risk.

If it was a penis, the rubbing without penetration (called frottage) was NOT a risk, however the penetration without a condom was a risk.

If you were penetrated by an unprotected penis, you need to confirm your negative result at the three month point.

The vast majority of people who have actually been infected will seroconvert and test positive by six weeks (42 days), with the average time to seroconversion being only 22 days.

A six week (or more) negative must be confirmed at the three month point, but is highly unlikely to change. I do not expect your negative result to change, but you do need to confirm at the appropriate time.

You should also be tested for all the other, MUCH more easily transmitted STIs. Many of them can be present with no obvious symptoms, so the only way to know for sure is to test. (Are you aware that untreated chlamydia is one of the leading causes of infertility in women? It often goes untreated due to the lack of obvious symptoms.)

Here's what you need to know in order to avoid hiv infection:

You need to be using condoms for anal or vaginal intercourse, every time, no exceptions until such time as you are in a securely monogamous relationship where you have both tested for ALL sexually transmitted infections together.

To agree to have unprotected intercourse is to consent to the possibility of being infected with an STI. Sex without a condom lasts only a matter of minutes, but hiv is forever.

Have a look through the condom and lube links in my signature line so you can use condoms with confidence. I suggest that you buy your own supply of condoms and make your partner(s) wear one before any anal or vaginal penetration occurs. Don't rely on men to supply their own condoms.

Anyone who is sexually active should be having a full sexual health care check-up, including but not limited to hiv testing, at least once a year and more often if unprotected intercourse occurs.

If you aren't already having regular, routine check-ups, now is the time to start. As long as you make sure condoms are being used for intercourse, you can fully expect your routine hiv tests to return with negative results.

Don't forget to always get checked for all the other sexually transmitted infections as well, because they are MUCH easier to transmit than hiv. Some of the other STIs can be present with no obvious symptoms, so the only way to know for sure is to test.

Use condoms for anal or vaginal intercourse, correctly and consistently, and you will avoid hiv infection. It really is that simple!

Ann

[Doglover55]

Thank you all for your advice. I have never made such a mistake, but alcohol excess seriously impaired my judgement. Stupid I know. I will most likely have a 3 mth confirmation. It seems there is much discussion regarding the CDC and whether their current three month guidelines are antiquated. Obsessing over this led me to find this fairly recent article discussing possible revisions. Have you seen it?
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6224a2.htm?mobile=nocontent

[Andy Velez]

For the timebeing we continue to follow the CDC recommendation of testing at 3 months for a conclusive negative result. Keep it simple, Dog. Test at 3 months, collect what I expect will be a negative result and get on with your life without doubts. 

[jkinatl2]

Thank you all for your advice. I have never made such a mistake, but alcohol excess seriously impaired my judgement. Stupid I know. I will most likely have a 3 mth confirmation. It seems there is much discussion regarding the CDC and whether their current three month guidelines are antiquated. Obsessing over this led me to find this fairly recent article discussing possible revisions. Have you seen it?
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6224a2.htm?mobile=nocontent

In some places (Massachusetts is one) the generation of testing is uniformly state-of-the-art (thanks to their awesome healthcare system) and as a result, the testing window there is six weeks.

However, until that becomes a GLOBAL standard, we really have little choice (seeing as this is a global web site) but to stick with the three months standard. I certainly relish the day when we can change that, of course.

[Ann]

DL,

Thank you for that link - it's very new and I hadn't come across it yet. I have read other papers on this method, but that's a newer study. (and it's looking good!)

However, the testing methods used in that study are also quite new and it will likely take some time before they are implemented in all areas of the US and the rest of the world. In this current global economic climate, that may take some years to achieve.

Until this testing method is used world-wide, we will still recommend that people confirm a negative result at three months.

After all, hiv is a serious illness and in order for people to live well with hiv, they first need to know they have it. If that takes testing out to three months, then that's what it takes. Better safe than sorry.

You would be prudent to test at three months to confirm, and don't forget to test for all the other MUCH more easily transmitted STIs as well. I cannot stress testing for ALL STIs enough, as so many of them can be present with no obvious symptoms.

As a woman, you should also be having regular, routine PAP smears too. You can kill several birds with one stone by having all the tests done at the same time. Do it - you'll thank yourself in the long run.

Ann

[Doglover55]

 Thanks Ann,  I did have all other STD testing and a PAP done. They were all negative. If I got the antigen/antibody test done then that would have been the same one in the study and what they are using in Mass.? I live in Colorado so I think we are pretty up to date in using the latest tests. I am unfortunately by genetics a "worry wart" and this fear is making me unable to care for my kids, work or function. Just want a definitive, but not sure I can deal with anxiety two more weeks. May have to test again before then.

[Ann]

DL,

Do what you need to do to get some peace. I just hope you realise that if you test sooner than the appropriate time for a conclusive result (twelve weeks), then you're likely to continue to doubt your results.

You are unlikely to go on to test positive after your negative result thus far, but you do need to confirm - at the APPROPRIATE time. Not before.

Ann

[Doglover55]

Hi Ann and all,
  Well you were right, I'm sure you never get tired of hearing that! I couldn't wait to be tested after my earlier posts so I had another fourth generation test done at 67 days. It was negative. My GP said that it was final proof that I was conclusively negative. The three month CDC recommendation just ate away at me though. I have wasted so much time on the internet that it's disgusting to me. Finally yesterday I broke down and because I couldn't face my GP again I bought the Oraquick at home hiv test. It was 23 weeks and it was negative. The only thing I worry about it if I got enough cells from the swab for an accurate sample. From reading online on their website it seems that if a line shows next to the control mark, C, then you have an appropriate sample. Do you know if that is true? Should I be concerned with a false negative and can I consider myself now truly conclusive?! This test at this time is a reliable and accurate test? I appreciate all the work you do here for the worriers like myself! It is a great service you provide.

[Ann]

DL,

If the control line appeared, then the test was done properly. That's why the control exists.

You are conclusively hiv negative and you do not need further testing over this specific incident. You would be wise, however, to get into the habit of yearly, routine sexual health check ups. It's what responsible people do in order to protect their own health as well as that of their partner's.

Use condoms for anal or vaginal intercourse, correctly and consistently, and you will avoid hiv infection. IT REALLY IS THAT SIMPLE!!!

Ann

[Doglover55]

Thank you Ann!
 That how I interpreted the test as well, but when I called their "support line" the operator said if I didn't swipe from molar to molar they wouldn't back the results. Seemed ridiculous to say that since that wasn't in the instruction packet. Trust me I would rather remain celibate for the rest of my life than to go through this anxiety I brought upon myself again. I will always use protection, common sense and get tested regularly in the future! Many thanks to you, JK and Andy for your responses. Time to take a deep breath and move on finally!

[Ann]

the operator said if I didn't swipe from molar to molar they wouldn't back the results.

DL,

That's what's called a CYA policy - cover your ass (against lawsuits etc). This isn't the place to further discuss corporate mentality.

The control line is there to show whether or not the sample/swab is sufficient and the kit is working properly. Yours was. You do not have hiv and I suggest you put this behind you once and for all. If you can't, then counselling is in order. There's nothing more we can do for you here.

Remember: Condoms. Always.

Ann